Individual
DR. LAUREN DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-9331
(310) 423-9399
Mailing address
PO BOX 512717, LOS ANGELES, CA 90051-0717
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A161692
CA
2086X0206X
Surgical Oncology Physician
Primary
A161692
CA
390200000X
Student in an Organized Health Care Education/Training Program
MT205763
PA
Other
Enumeration date
06/09/2014
Last updated
12/29/2021
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